A breast lift, or mastopexy, is performed to return youthful shape and lift to breasts that have sagged as a result of weight loss, pregnancy, loss of the skin's natural elasticity or simply the effects of gravity. The procedure can also reduce areolar size (the dark skin surrounding the nipple), and it can be combined with augmentation mammaplasty (breast augmentation) for added breast volume and firmness. Breasts of any size can be lifted, but results last longest when they are originally small and sagging.
Women planning to have children are advised to postpone surgery, since pregnancy and nursing can counteract its effects by stretching the skin. However, a breast lift should not affect your ability to breast-feed.
Breast lifts are usually done on an outpatient basis under general anesthesia, and last from 1-½ to 3-½ hours.
A number of pre-operative steps are typically taken such as a mammogram, measurement of the breast landmarks, and discussion with the surgeon about the desired size and shape of the breast and placement of the nipple. During the procedure, incisions are made to reposition the nipple and remove excess skin. The surgeon removes excess skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. The resulting scar may be anchor or lollipop shaped.
After breast lift surgery, gauze dressings and a surgical bra is placed. This bra will be worn post surgery until your surgeon tells you otherwise. Breasts may be bruised, swollen, and uncomfortable for a few days but this will pass. Numbness in the breasts and nipples should lessen as swelling subsides, although occasionally it lasts for months or even permanently.
Complications are uncommon but may include bleeding, infection, numbness, uneven positioning of nipples and widening of scars. Scars can be covered even beneath bathing suits and low-cut tops. You and your surgeon should have a full discussion of the risks and benefits of breast lifting surgery.
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Large breasts can cause pain, improper posture, rashes, breathing problems, skeletal deformities, and low self-esteem. Breast reduction surgery is usually done to provide relief from these symptoms. Performed under general anesthesia, the two- to four-hour procedure removes fat and glandular tissue and tightens skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body.
Breast reduction surgery is not recommended for women who intend to breast-feed, since many of the milk ducts leading to the nipples are removed.
During the breast reduction procedure, an incision will be made to reposition the nipple and remove excess skin and tissue. The surgeon removes excess glandular tissue, fat, and skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. The scar may be anchor shaped or lollipop shaped. Liposuction may be added to remove excess fat from the armpit area if needed or desired, and in cases when only fat needs to be removed from the breasts, liposuction alone may used for breast reduction.
For a few days after surgery, a surgical bra holds dressings in place and you may be given surgical drainage tubes for fluid removal. The drainage tubes are removed in the hospital or the office, depending on the procedure. Your surgeon will indicate to you when a regular bra may be worn.
A little pain is normal after breast reduction, whether mild discomfort, swelling during menstruation, a measure of numbness or sensitivity, or random, shooting pains that may last for a few months. Swelling, bruising, crusting and slight changes in breast size are also common. Most patients return to work in about two weeks, although you should avoid heavy lifting for four to six and only gentle contact with the breasts should occur for six weeks.
Scars fade with time but will not disappear, although they can be hidden with a bra, bathing suit or low-cut top.
Risks are rare and usually minor but may include bleeding, infection, reaction to the anesthesia, small sores around the nipples, slightly mismatched breasts or unevenly positioned nipples, and permanent loss of feeling in the nipple or breast. You and your surgeon should have a full discussion of the risks and benefits of breast reduction surgery.
Many women may have their breast reduction surgery covered by their health insurance plan. In order for insurance to cover a breast reduction, there must be documentation of pain and failure of non-surgical treatments to alleviate the pain. A certain volume of tissue must also be removed which may vary from patient to patient and between insurance companies. Our office will help you determine what documents are required for precertification and give you assistance with obtaining coverage whenever possible.
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Although rarely discussed, enlarged male breasts is a common condition. Gynecomastia affects approximately 40 to 60 percent of men. There is often no known cause for gynecomastia, although there has been some correlation with various drugs or medical conditions. Men who feel self-conscious about their appearance are helped with breast-reduction surgery. The procedure removes fat and/or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a contoured chest that is flatter and firmer.
